Received: 03.04.2025 Accepted: 12.04.2025 Published online: 29.04.2025
UDC: 618.146-076.5
DOI: 10.53511/pharmkaz.2025.2.3
CYTOLOGICAL DIAGNOSTICS OF SCREENING WITH HPV TESTING
AS AN EARLY MARKER OF CERVICAL CANCER
Gulnara Zh. Sakhipova1, Saule Zh. Akhmetova1, Klara K. Kanguzhieva2, Aynagul A.Khairullina1
1Non-Profit Joint Stock Company «M.Ospanov West Kazakhstan Medical University»,
Aktobe, Republic of Kazakhstan
2 State municipal enterprise «Regional pathological anatomical bureau»
Aktobe, Republic of Kazakhstan
Introduction. WHO has put forward a three-pronged approach to eliminate the social problem: 90% coverage of
HPV vaccination among girls by the age of 15, 70% of women from the age of 35 coverage of screening using a
highly effective test and treatment of cervical cancer at an early stage, and adequate treatment of cervical cancer
in 90% of women. Expectation: preventing 74 million new cases of cervical cancer and 62 million deaths in 78
low- and middle-income countries in the coming decades
The purpose of the study: clinical validation of HPV testing with cytology for early detection of cervical cancer.
Methods and materials: The examination was carried out according to a generally accepted protocol: clinical
examination, preparation of cytological smears using liquid leukocytology, evaluation of smears using the
Bethesda system, detection and genotyping of high-risk HPV DNA on a Cobas 4800 device, which is a fully
automated system, and extended colposcopy.Study design: prospective-cohort.
Results: The number of women screened tended to increase: in 2021 — 27,163 women; in 2022 — 29,205 women;
in 2023 — 27,396 women; in 2024 for 9 months — 25,819 women. A total of 109,583 women were examined, of
which 4,359 women had pathological changes. The age range of the women studied: 30 years — 70 years, the
average age is 50 ± 8.2 years. The results of cytological screening by liquid cytology for the period from 2021 to
2024 showed that among 4359 women, atypical cells of multilayer squamous epithelium of unclear value were
detected in 144 (3.3%), mild dysplasia in 252 (5.7%), severe dysplasia in 167 women (3.8%), suspected cancer
in 40 cases (0.9%) cancer in 8 cases (0.2%). HPV 16 was detected in invasive cancer in 72.8% and in CIN 3 in
65.5%, VPCh-31 in 11%, HPV 33-in 11.3%, HPV 52 in 11.6%, HPV 58 in 12%, when VPCh-18 was detected much
less often, in 5.2%.
Novelty of the study: the sensitivity of the PCR method for detecting HPV of high oncogenic risk (65.5-72.8%)
exceeds the sensitivity of the cytological study (42-50%).
Practical application of the study: HPV testing, as a marker of dysplasia and carcinoma, can play a leading role
not only in triaging patients with low-grade cytological abnormalities of the cervix, but also increase
oncongreatedness for cervical cancer depending on the patient’s age.
Keywords: clinical validation, HPV testing, fluid cytology, cervical cancer, dysplasia, extended colposcopy

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